{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:18:25Z","timestamp":1793146705796,"version":"4.5.0"},"reference-count":26,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Pediatric hemovigilance is a nascent field in transfusion medicine. The lack of standardized hemovigilance reporting in the US makes it difficult to determine age-specific transfusion reaction rates and risks.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the rates and epidemiology of transfusion reactions reported to transfusion services in neonatal and pediatric populations.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study analyzed transfusion reactions occurring in children younger than 18 years reported to 8 hospitals\u2019 transfusion services during April 1, 2019, through December 31, 2023. Data were evaluated from March 2024 to June 2025 using standardized data collection forms and associated electronic health records.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Patients who received transfused blood products (red blood cells [RBCs], platelets, plasma, or cryoprecipitate) with at least 1 transfusion reaction reported to the transfusion service.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Reaction rates per 100\u202f000 products transfused were calculated. Pediatric transfusion reactions were characterized in detail, including reported severity and imputability; product type; patient age, sex, race, and ethnicity; and reported symptoms, premedication, and clinical management.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The sample included 228\u202f886 products transfused to 22\u202f628 patients (median [IQR] age, 4.2 [0.3-12.4] years; 127\u202f903 males [55.9%]). The products were transfused to patients of Asian (18\u202f649 [8.2%]), Black (37\u202f673 [16.5%]), White (93\u202f824 [41.0%]), multiracial (3680 [1.6%]), other (68\u202f857 [30.1%]), or unknown race (6203 [2.7%]) and Hispanic or Latinx (52\u202f398 [22.9%]), non-Hispanic and non-Latinx (144\u202f017 [62.9%]), and unknown ethnicity (32\u202f471 [14.2%]). A total of 1165 imputable transfusion reactions were reported, with an overall reaction rate of 0.52% (95% CI, 0.49%-0.55%). Patients aged 5 to 11 years had the highest reported transfusion reaction rate (891.11 [95% CI, 799.81-989.11] per 100\u202f000 products transfused). Platelet transfusions had the highest transfusion reaction rates (821.75 [95% CI, 754.14-893.80] per 100\u202f000 products transfused), with allergic reactions being most common (506.04 [95% CI 453.30, 563.24] per 100\u202f000 products transfused), whereas RBC transfusions had more reported febrile nonhemolytic transfusion reactions (FNHTRs; 296.20 [267.06, 327.67] per 100\u202f000 products transfused) than other types of reactions. The most common symptoms were urticaria (69.6% [368 of 529 patients]) in allergic reactions, fever (96.5% [559 of 579 patients]) in FNHTRs, and acute respiratory distress (87.5% [21 of 24 patients]) in transfusion-associated circulatory overload (TACO); the most common treatments were antihistamines (80.3% [425 of 529 patients]) for allergic reactions, antipyretics (67.9% [393 of 579 patients]) for FNHTRs, and diuretics (83.3% [20 of 24 patients]) for TACO. Many patients (35.8% [107 of 299]) did not receive premedication after the first reaction in subsequent transfusions, regardless of reaction type. When transfusion reactions recurred, they were often of the same type (77.9% of reactions [120 of 154] after allergic reactions were allergic; 72.1% of reactions [98 of 136] after FNHTRs were FNHTRs).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of pediatric transfusion reactions, reactions appeared to be age dependent, and rates of allergic reactions and FNHTRs were higher than rates from previously published, possibly underreported, predominantly adult data. These findings underscore the importance of pediatric-specific hemovigilance to improve recognition, reporting, and safety monitoring of transfusion reactions.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.9274","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T15:30:47Z","timestamp":1777303847000},"page":"e269274","source":"Crossref","is-referenced-by-count":2,"title":["Epidemiology of Pediatric Transfusion Reactions"],"prefix":"10.1001","volume":"9","author":[{"given":"Elizabeth F.","family":"Stone","sequence":"first","affiliation":[{"name":"Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Chacreton","sequence":"additional","affiliation":[{"name":"Clinical Research Practice, Westat, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology and Laboratory Medicine, Weill Cornell Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California San Francisco Benioff Children\u2019s Hospital, Oakland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruchika","family":"Goel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Simmons Cancer Institute, Southern Illinois University School of Medicine, Springfield"},{"name":"Corporate Medical Affairs, Vitalant, Scottsdale, Arizona"},{"name":"Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne E.","family":"Hendrickson","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Center for Transfusion and Cellular Therapies, Emory University School of Medicine, Atlanta, Georgia"},{"name":"Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne E.","family":"Nellis","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Pediatrics, Weill Cornell Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Sola-Visner","sequence":"additional","affiliation":[{"name":"Division of Newborn Medicine, Boston Children\u2019s Hospital and Harvard Medical School, Boston, 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Oakland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Wilson","sequence":"additional","affiliation":[{"name":"Clinical Research Practice, Westat, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey J.","family":"VanWormer","sequence":"additional","affiliation":[{"name":"Marshfield Clinic Research Institute, Marshfield, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia Titi","family":"Singer","sequence":"additional","affiliation":[{"name":"Hemoglobinopathy Reference Laboratory, Department of Hematology\/Oncology, University of California San Francisco Benioff Children\u2019s Hospital, Oakland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Bakhtary","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University of California San Francisco, San 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